Circumcision and HIV infection: review of the literature and meta-analysis

Int J STD AIDS. 1999 Jan;10(1):8-16. doi: 10.1258/0956462991913015.


Thirty-five articles and a number of abstracts have been published in the medical literature looking at the relationship between male circumcision and HIV infection. Study designs have included geographical analysis, studies of high-risk patients, partner studies and random population surveys. Most of the studies have been conducted in Africa. A meta-analysis was performed on the 29 published articles where data were available. When the raw data are combined, a man with a circumcised penis is at greater risk of acquiring and transmitting HIV than a man with a non-circumcised penis (odds ratio (OR)=1.06, 95% confidence interval (CI)=1.01-1.12). Based on the studies published to date, recommending routine circumcision as a prophylactic measure to prevent HIV infection in Africa, or elsewhere, is scientifically unfounded.

PIP: This article reviews the literature on circumcision and HIV infection. Recent studies show raw figures suggesting circumcised men to be at greater risk for HIV infection. Circumcised men have been found to also have more sexual partners. Findings explain that circumcision may be responsible for the increased number of partners, and therefore, the increased risk. In Africa, the use of dirty instruments and mass ritual events, including group circumcision, may increase the number of young boys developing HIV infections. Based on the studies published in the scientific literature, it is incorrect to assert that circumcision prevents HIV infection. Moreover, even if studies showing circumcision to be beneficial are accurate, the risk from circumcision outweighs any small benefit it may have. Thus, promoting circumcision as protection against HIV infection would lead to the belief that circumcised men are being protected from contracting AIDS, which would result in increased HIV infections.

Publication types

  • Review

MeSH terms

  • Circumcision, Male*
  • HIV Infections / prevention & control*
  • Humans
  • Male
  • Meta-Analysis as Topic